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Archived: Monet Lodge

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Inspection report

Date of Inspection: 20 December 2012
Date of Publication: 26 January 2013
Inspection Report published 26 January 2013 PDF | 94.92 KB

People should be given the medicines they need when they need them, and in a safe way (outcome 9)

Meeting this standard

We checked that people who use this service

  • Will have their medicines at the times they need them, and in a safe way.
  • Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

How this check was done

We reviewed information sent to us by other organisations, carried out a visit on 20 December 2012, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with stakeholders.

We were accompanied by a Mental Health Act commissioner who met with patients who are detained or receiving supervised community treatment under the Mental Health Act 1983.

Our judgement

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Reasons for our judgement

We spoke with four people who were being cared for in this hospital and four sets of relatives of people who were being cared for in this hospital about the care they received. One person who used the service told us: "I don’t know what it is [the medication the person was on] but I am happy to speak to staff about it".

We looked at the medicine administration record charts (MAR charts) for people being cared for in the hospital. This showed that people were receiving medication at the right times and at the correct dosages. The hospital had a system to ensure that where people were prescribed body creams that there was a body map placed with the MAR chart to guide nursing staff where and how thickly the prescribed cream should be administered.

We saw that the hospital was monitoring the use of anti-psychotic medication prescribed for people with dementia. This meant that the hospital was acting in accordance with national guidance. The hospital was also accountable to the primary care trust (PCT) for ensuring continuous monitoring of anti-psychotic medication prescribing as part of its contractual commitment for quality improvement.

We looked at the controlled drugs systems. Controlled drugs are stronger drugs that need to be stored and accounted for through special procedures to keep people safe. Controlled drugs were stored in a locked cabinet and a random check of a sample of controlled drugs showed that the records kept were accurate.

We saw that four people were currently detained under the Mental Health Act. The Mental Health Act has special rules around medication for mental disorder, including a formal procedure and safeguard if treatment is given beyond three months (section 58 of the Mental Health Act). Where people had been detained under the Mental Health Act for more than three months, the hospital had procedures in place to ensure that these special rules and safeguards were adhered to. The medication records relating to people detained were seen by the Mental Health Act Commissioner (MHAC) who confirmed that the hospital was complying with the Mental Health Act in relation to rules around treatment. We also saw that improvements had been made to the hospital's processes following Second Opinion Appointed Doctor (SOAD) visits as recommended by the last MHAC visit. None of the informal patients were receiving covert medication. Staff had a good understanding of their professional responsibilities should covert medication be required.

The hospital could not locate an available updated copy of the British National Formulary (BNF). This is a reference book with all updated information about drugs for nurses, doctors and pharmacists. We saw evidence that the hospital had purchased a recent BNF. The hospital should ensure that this important reference source is available at all times.

We saw a recent independent pharmacy audit which showed that the hospital's systems for managing medicines was good with a few minor improvements which the hospital had progressed.